Athlein

I think it would help if you clarified your long-term medical education/research goals. I completed a medical research internship as a post-baccaleaureate, and I came away with a completely different understanding of what it takes to succeed in this realm. Ask yourself what it is that you really want to do. Provide direct patient care or work in a research setting or teach? Do you want to head the research and conduct science-based investigations, or do you want to explore clinical phenomenon as a part of a team? And if it's teach, then teach what? Medicine/science or nurse anesthesia? It will be difficult to choose a path until you answer these questions. Remember that the CRNA role is a clinical specialty, and while there are many opportunities for educators in CRNA programs, direct patient care is an integral part of nurse anesthesia practice, which is why the vast majority of CRNAs can be found at the head of the bed, not at a desk.

Where the heck do you go to school where you can get to the gym before and after school? The only thing I can figure is that you are still in your didactic phase, because now that clinicals have begun, I am up by 5 to get to the hospital on time, and when I get home, I have anesthesia plans to write, studying for classes to accomplish, and, oh, sleep in there somewhere. You may be in clinical for only 8 to 10 hours, but I swear, when you come home, you are just exhausted. Seriously, at least in my case - and the case of classmates and the other SRNAs I know, once clinicals started, all bets were off regarding any semblance of schedule and routine. Exercise and fitness are crucial to maintaining your health and sanity during anesthesia school, but understand that you can't get something for nothing. I'm getting up at 0400 a few times per week to stick to my fitness goals. The tradeoff? Caffeine is now a physiologic necessity for cerebral function!

MJB, I think college is going to teach you a great deal. Do you have a roof over your head, food on the table, and clothes on your back? If so, then you are not as poor as you think. As you grow up, you will realize that affluence and wealth do not necessarily guarantee any sort of life security. And you will also realize that the lack of options you bemoan may in fact be attributed to flawed perception on your part. There are plenty of opportunities out there for students who do not have life's every advantage. I can attest to that personally.

Ditto about Kaplan. I can't speak to other review courses, like Princeton, but I can tell you that the methods and review that you receive from the Kaplan study materials are outstanding - if you are a dedicated and self-directed student. I scored in the 80th and 90th percentile my first time on the GRE. It was not luck. The materials work if you put the time into studying them.

The anticholinergics - atropine and glycopyrrolate specifically in this discussion - are competitive antagonists of acetylcholine at all the muscarinic receptors. However, there is compelling evidence that these drugs are not PURE anti-muscarinics. It is theorized that the bradycardia seen at low doses is attributed to the drug's peripheral muscarinic agonist effect. Theories that bradycardia could be due to central vagal MOA were refuted by the facts that: 1. low-dose brady could be demonstrated with glycopyrrolate, as well, which does not readily cross the CNS. 2. bradycardia occured with low-dose administration of atropine, scopolamine, and glycopyrrolate even with the interruption of the vagus nerve impulses (AKA vagotomy).

Consider this: It's a short trip from driven to desperate. Admission to a CRNA program is more than just admission to a school - it is an admission to the profession. When I say that it takes more than GRE and GPA to gain admission, I am also referring to the intangibles of personality, ability to achieve and reflect positively on the nurse anesthesia profession, and professional demeanor. CRNA programs look carefully for "personality pathology", whether you realize it or not. The best way to stand out in the admission process is to interview well. Understand, too, that wait-listing or denial is not necessarily a statement against your personality, attributes, or character. In this time of very competitive applicant pools, there just may be nurses that are a better fit for the particular program. Schools have a general idea of who will be a successful student in their program. That is a part of the admission process that simply cannot be changed. I know the waiting and stress is tough. Here's a quote from Alexander Graham Bell to ponder: "We so often look so long and so regretfully upon the closed door, that we do not see the ones which open for us".

A couple of corrections: 1. SMC is not truly front-loaded. There is a single didactic-only semester in the Fall of your first year. Clinicals start in the Winter semester of your first year. 2. Commuting is an integral part of the program. It's not a question of if, but when. In short - excellent program, significant clinical time with great experiences, dedicated faculty that really want to see you suceed. But, you can't get something for nothing. It is very tough. And no one coasts through their program.

One of the CRNAs affiliated with the COA told us that about 80% of the programs in this country are quality programs. The other 20%? Well.... I think there is some merit to the rankings process. I thought of several programs that would make my top-ten list, and sure enough, they were all right up there on the USNews list. It shouldn't be the determining factor in your decision-making process, however! PS The USC program in LA is alive and well. It just moved to the med school when the USC nursing program was eliminated.

Dustin, Hats off to you for realizing that money does not necessarily equal career happiness. Finding a good fit for you in nursing is more important than chasing a paycheck! Flight nursing and anesthesia share autonomy and independent decision-making, as well as generally happy nurses in that specialty. And dang it, it is just cool to fly around in a helo or fixed-wing and get paid for it! Coming from high-acuity ER and ICU, I will tell you that that the routine nature of the CRNA role can be, well, mundane at times when compared to the fast-paced nature of those units. I am not bored by any means, but the very definition of good anesthesia is calm, controlled, and preemptive action. Sometimes I miss those blowout MIs and traumas with all the drama and action that go along with them. At the end of one of those days, I really felt like I helped save a life! There are several CRNAs I know that worked in flight nursing in their younger days that returned to the unit for a year or so before attending anesthesia school. One of the coolest CRNAs I know was an trauma flight nurse for many, many years and well-known in flight nursing circles. Now he works in our big level I public hospital trauma center as a CRNA. Why not do both?!

Hey Gooser, I think your concerns are valid. It is stressful and anxiety-producing to play the admissions game - that is unavoidable. When you consider that your first interview did not result in admission, that outcome contributed to the tension you already carry. Sometimes, the focus on our goals and plans becomes too narrow. We worry, we stew, we "what if?"...we try too hard! My advice? Take a mental break from the admissions process. Put it on the shelf for awhile and come back to it when your next interview draws near. Limit your CRNA-related internet surfing and school literature reading. Do some things you enjoy with your family and friends. And, remind yourself that you will get in, somewhere, when the time is right!

There are only four schools West of the Rockies (Gonzaga in Spokane, Washington; Samuel Merritt in Oakland; Kaiser/CSUF in LA, and USC in LA). Competition for the limited number of slots is very tough. All the schools are excellent, but they are distinctly different from one another, so taking the time to research these programs is time well spent. Only Gonzaga, in Spokane, Washington, fits your priorities if you do not want to travel to clinical sites and/or live in an urban setting in California. If you don't want to spend time behind the wheel of your car, the California programs are not for you. Going to different clinical sites has a number of drawbacks, but the distinct advantage it offers is learning the myriad ways to accomplish anesthesia. There are many, many ways to "skin the cat" in anesthesia. Getting exposed to a variety of techniques and methods while you are a student will serve you well in practice; admittedly, it can be time-consuming and difficult. FYI - Directors and admissions offices are usually inundated with requests for information and questions from applicants in the current cycle during this time of the year. Research schools on the web and receive the informational packet from the program first.

WntrMute2 has it spot-on. I have also heard that Florida, Colorado metro areas, and California can be tough in terms of scope of practice (not from a legislative point-of-view, but from one of limited scope by hospitals and MDAs [excluding the managed care setting of Kaiser Permanente]). Desirable areas attract more physicians, generally speaking. Also, there is a funny rule about CRNAs + ambulatory surgical centers + pediatrics in Florida, but I do not know the specifics. Maybe one of the Barry SRNAs can give us the scoop.

Woo-hoo! Congratulations!

Gooser, Hang in there! If you went to the interview prepared, answered the questions to the best of your ability, and kept your anxiety in check, then shrug your shoulders and move on to the next interview. You were smart to contact the director of the program and ask why you were not selected. Understand, too, that some program admissions committees have a very narrow idea of what constitutes a suitable student for their programs. What is "interested and enthusiastic" for one school may be "gushing and suck-up" to another. Here is something that might make you feel better: I know a CRNA who went to a smaller school that took "interested and enthusiastic" to mean "doormat and kiss-a$%" once admitted. That environment makes for a long two and a half years. Beware of programs that make you feel like you are lucky to be in their presence. If that's the attitude they extend when they are interviewing you, what would student life be like?!

Yep, it's paper and pen for me. I have a Handspring Visor, but it is going to be used for Epocrates and storing contact information.